Virtual reality simulation of fluoroscopic navigation.

Abstract

Surgical navigation systems assist surgeons by tracking targets attached to the patient's bones and to the surgical tools. Fluoroscopic navigation is a technology that adds "live" imaging to surgical navigation. In order to identify the limitations and potential sources of errors in fluoroscopic navigation, a virtual environment is created in which all the key steps of fluoroscopic navigation can be rehearsed. This provides a low-cost, highly portable, and radiation-free training environment with the ability of instant accuracy validation and reliable measurement of trainee progress. This virtual environment also is suitable for comparing different fluoroscopic registration techniques and protocols. Although the imaging component of the navigation is simulated, physical interaction with the environment can be modeled at different levels; from a fully virtual environment, to miniature models, to life-size dummies and cadavers. Each of these options satisfies different specific training needs, such as the need for portability and easy setup to the need for a completely realistic simulation of the entire clinical environment and operating procedure. In this study, we present the example of a system based on a scaled-down model with a specific focus on analyzing and training bony landmark localization using fluoroscopic navigation.